1. Field of the Invention
This invention relates to an instrument including an electrosurgical apparatus, such as a laparoscopic tube end used for performing laparoscopic, pelvoscopic, arthroscopic, thoroscopic and/or similar such procedures, and more particularly to an electrosurgical apparatus having a connector for fluidically sealing, isolating and electrically insulating a detachable tip when engaged with a laparoscopic tube end.
2. Background of the Invention
Medical procedures such as laparoscopy and the like, which employ a tip at the end of a tube for insertion into the patient, are beneficial because the incisions necessary to perform them are minimal in size, therefore promoting more rapid recovery and lower costs. For example, a patient who undergoes laparoscopic surgery may typically return to normal activity within a period of a few days to about a week, in contrast to more invasive procedures requiring a relatively larger incision (which may require about a month for recovery). Although the term “laparoscopic” is typically used hereinafter, such use of the term “laparoscopic” should be understood to encompass any such similar or related procedures such as, for example, arthroscopic, endoscopic, pelvoscopic and/or thoroscopic or the like, in which relatively small incisions are used.
However, when a tip is detachably connected to the tube end of a laparoscopic device, complications may occur if fluid breaches the connection and enters the interior of the tip or tube end. For example, septic contamination may arise in the laparoscopic device and/or electrical current may unintentionally leak therefrom. After each laparoscopic procedure, the device is also exposed to brushing, chemicals for cleaning and/or sterilization by various methods which may include heating, cooling, and flushing with additional chemicals. The seal in the handpiece may degrade to the point where it loses its integrity (either over use of hundreds of cycles, or from handpiece abuse; which can result in unintended cautery causing damage and injury to structures around a surgical site).
The practice of reprocessing and reusing single-use devices (SUDs) has become increasingly more common because of costs savings and the reduction in waste. However, reprocessed SUDs, such as cutting blades, often do not function as well as SUDs that have not been reprocessed. For example, in the case of reprocessing a cutting blade, the blade may be dulled during the surgical procedure or may be damaged during the reprocessing process such that the cutting blade no longer cuts or opens and closes with the desired or required precision. Further, due to the extensive nooks and crannies, SUD's often cannot be thoroughly sterilized. Therefore, a reprocessed tip, such as those including a cutting blade, may not operate as well after reprocessing any may even result in harm to the patient. Therefore, it is possible that any subpar operation of the reprocessed tip may be incorrectly attributed to the original manufacturer of the reprocessed tip, which may result in damage to the reputation of the original manufacturer.
FIG. 1 shows a tube end 11 of a reusable handpiece 200 to which a conventional tip (which may be a SUD) 20 may be removably attached. The tip has an end effector 202 in the form of a scissors, grasper and the like. The tube end 11 distally extends from a tube 61, which in turn distally extends from the handpiece having handles (or other suitable controls, not shown, for actuating the tip 20) operable by the medical personnel or physician performing the surgery. The tube end 11 includes an elastomeric tube end seal 15, which is typically made from EPDM (ethylene propylene diene monomer). It is often difficult for users to detect when a seal 15 has worn to the point where integrity has been lost. Once integrity is lost, collateral damage can occur any time electrosurgical energy is applied to the device. In the illustrated device, the laparoscopic surgical tip 21 is assembled to the tube of the handpiece 200 using a dual-threaded threaded connector. In other words, the tip 20 includes a yoke 150 having external threading 551, which engages complementary internal threading on an actuation rod (not shown) extending along the length of the tube 61 (thereby providing for the actuation of the end effector), and a back hub 400 includes internal threading (not shown) which engages complimentary external threading 21 on the tube end 11 to secure the back hub to the tube 61. Such an attachment typically creates a 50 pound load on the attached components. The seal 15 on the handpiece 200 is compressed by the back hub to create a barrier for electricity and fluids. FIG. 2 shows an surgical tip affixed to a handpiece 200 of FIG. 1 with a heat shrink 25.
FIG. 3 illustrates a laparoscopic device in which, rather than a seal 15, a piece of flared heat shrink 25 is used on the disposable tip 20 to create a seal with the tube 61. Also, the device of FIG. 3 does not use the dual-threaded design of FIGS. 1-2, but instead uses a single threaded connection (between the tube end and the back hub) and a ball 41-and-clevis arrangement to connect the actuation rod to the yoke (for actuation of the end effector).